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Writing the Discussion Section: Describing the Significance of the Study

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Article  in  The Journal of the Association of Physicians of India · November 2015

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40 Journal of The Association of Physicians of India ■ Vol. 63 ■ November 2015
Writing the Discussion Section: Describing the
Significance of the Study Findings
Sandeep B Bavdekar
Abstract
The Discussion section is an important part of the research manuscript
that allows the authors to showcase the study. It is used to interpret
the results for readers, describe the virtues and limitations of the study,
discuss the theoretical and practical implications of the research work
done and provide important “take home” message.
T he Discussion section of a
paper intends to convey what
the findings of the study mean
and hence has been likened to
the closing arguments put forth
by counselors in a court case. It
is the last chance for an author to
“sell” his paper. The discussion
section should be written in a
focused manner getting straight to
answering the research question
raised in the introduction section.
Such a direct approach is likely
to make a lasting impression on
the minds of the readers. The
discussion section is considered
harder to define as compared to
the other sections of the research
paper. While other sections
require orderly and simple logical
writing; composing discussion
section requires logical thinking,
reflection and critical appraisal.
A well-written discussion section
includes a statement of important
results, reference to previously
p u b l i s h e d r e l e va n t l i t e r a t u r e ,
comparison of study results with
previously reported findings,
explanation of results, elucidations
of strengths and weaknesses of the
study, interpretation of the whole
evidence, description of impact of
the study and recommendations for
the future course of action.
Art of Writing
findings (3) . Some find it prudent
to re-state the purpose of the
study, using a terminology similar
to that used in the Introduction
section and answering the question
raised in the introduction. This
is an acceptable reiteration, as
the Introduction and Discussion
section are separated by other
sections. While describing the gist
The Structure
The beginning: Most authors
of the results, the authors must
include all important observations.
They must report on the primary
prefer to begin this section by outcome, irrespective of the fact
providing a summary of the key whether these are in line with the
findings in the study. Such a stated hypothesis or not.
summary offers context to the
The next part of the Discussion
debates and arguments that follow.
should be devoted to interpreting
In addition, there are readers; who
the results, citing the strengths
after reading the title (do not read
and limitations of the study, and
the methodology or the Results
listing the implications of the
sections, but) straightaway go
study findings in the light of
to the Discussion section to find
whole evidence. This should begin
out the implications of the study
with comparing and contrasting
findings. These readers need to
the study results with those of
be provided with a gist of results,
other relevant studies. However,
to enhance their understanding of
it is advisable for authors to desist
the discussion. However, it must
from providing a detailed critique
be remembered that there is no
of each and every study on the
reason to provide details of all
topic. Studies with similar as
observations, as the readers who
well as differing results should
are interested in such detailed
be cited. The possible reasons
accounts have a whole section
for differences in the results
dedicated to study findings. Some
can then be discussed (3) . Getting
p refer to b eg in t he discussion
results that are different from
section by stating the important
previously conducted studies does
conclusions of the study, while
not necessarily mean that there
there are others, who prefer to
has been some error or mistake
begin the section by narrating why
in conducting the study. It could
the study is special or unique and
simply be due to differences in
then go on to discuss the study
the populations studied. It is also
Professor and Head, Dept. of Pediatrics, Topiwala National Medical College and BYL Nair Ch. Hospital, Mumbai,
Maharashtra
Received: 18.07.2015; Accepted: 28.07.2015

Table 1: Common pitfalls
Pitfall
Providing results in great detail
Discussing observations not reported Only observations reported in the Results section
in the Results section
Avoiding discussion on unexpected Discuss unexpected results and try and explain results
results
Same or similar information is
provided in introduction and
discussion sections
Long, wordy arguments that meander Use focused arguments
Using discussion section to provide
historical details or irrelevant
information. Comparing study
findings all the studies done on the
subject.
Not listing study limitations
Conclusions not supported by the
data or over-inflating the importance data. Always provide a balanced and honest viewpoint.
or ‘generalizability’ of the study
findings
Speculating too much or too little
possible that the differences were
because of a more sensitive or
specific test used in the current
study. The authors can also
attempt to explore the possible
mechanisms or explanation for the
study findings. If there have been
some unexpected findings, these
should be reported honestly and an
attempt should be made to explain
their occurrence, if possible. These
findings could sow the seeds of
future exploration and research.
The authors can then describe
h o w t h e s t u d y wa s u n i q u e o r
different and what were the
strengths and limitations of the
study. The strengths could be
related to objectives of the study,
participant characteristics or
conduct of study. For example,
the present study may have had
a better choice of the research
question, a stringent selection of
an appropriate study population,
or an intervention similar to that
used in the medical practice. In
addition, it might have employed a
more sensitive or more specific test
Journal of The Association of Physicians of India ■ Vol. 63 ■ November 2015
Corrective Action
A gist of results is enough to provide context for the
discussion that follows
should be discussed
not in line with the hypothesis. Be honest. These could
stimulate further research
Introduction and Discussion sections should
complement each other (Table 2). It is necessary that
arguments begun in Introduction are followed through
in the discussion section, but repetition of ideas and
arguments should be avoided.
Compare study findings with those from recent,
relevant high-quality studies in order to hold the
readers’ attention.
Not a good idea. Reviewers will point to them out,
anyway
Avoid drawing conclusions that are not backed by
Discussion section should be used for predicting how
results would impact practice, health policy and future
research. Such predictions help readers understand
the value of the research study. But exaggerations and
excessive speculation should be avoided as it would
bring discredit.
for screening or diagnosis, enrolled
an appropriately large participant
population (adequate sample size),
ensured a higher compliance and
lower drop-out rates or used an
objectively assessed and clinically
r e l e va n t e n d p o i n t , o r u t i l i z e d
various effective methods to
minimize bias.
Many newly-initiated authors
t e n d t o s h y a wa y f r o m l i s t i n g
limitations in the study thinking
that if they point out weaknesses
in their study, the probability of
manuscript being rejected would be
higher. This is far from the truth. It
is well to remember that no study
is perfect and that every study has
one or the other limitation. In any
case, the editors invite experts to
review the manuscripts. In such a
situation, these expert reviewers are
anyway going to identify and point
out the weaknesses in the study.
And then they would have the
impression that the investigators
have planned and executed the
study and are now reporting the
study findings without having any
41
idea about the limitations of their
study. It is better for the authors to
point out the possible weaknesses
such as sources of imprecision and
sources, magnitude and directions
of potential bias. They can also
elaborate on the efforts taken to
minimize these errors and maybe
even clarify why they could
not be eliminated or controlled
further. The authors can then go
on to discuss the impact of these
limitations on the study findings
and argue how the results can still
be considered valid in spite of the
listed limitations.
After having presented the
whole evidence (from the previous
studies and the current study)
and having critically analyzed
the study quality (in terms of
limitations and strengths); the
authors should may then provide a
balanced interpretation of the whole
evidence, citing what the study has
added to the current knowledge and
how it has enhanced understanding
of the subject. They then need
to discuss the generalizability
( va l i d i t y a n d a p p l i c a b i l i t y ) o f
the study findings and based on
the totality of evidence should
state if and how clinical practice
(diagnostics, therapy or preventive
strategy) and/ or health policy
needs to change. While reporting
on these aspects, care should be
taken to ensure that the conclusions
are based on the study data, and
the importance of the study is not
exaggerated. The last paragraph
of the section should show-case
the study, stating clearly whether
the study findings support the
hypothesis or not. The authors
can also list the new questions
and controversies raised by the
study and explore implications of
the study findings for the clinical
practice and future research.
Pitfalls to Avoid
Discussion section needs to be
written with great care and thought,
as it informs the reader about the
significance of the study. And it
is necessary that authors plan it
42 Journal of The Association of Physicians of India ■ Vol. 63 ■ November 2015

Table 2: Comparison between the Introduction and Discussion sections the evidence generated by earlier
Introduction Section Discussion Section studies at a glance.
Purpose To help reader understand To help reader interpret the results and To summarize, discussion
the need to conduct the understand the implications of the study section is considered to be the
research study findings
most important section of a
Research Question Narrates the hypothesis or Provides answer to the research question
the research question and states if the study findings support
research manuscript, as it puts the
the hypothesis study findings in an appropriate
Contents Information about the Summary of study findings, explanation p e r s p e c t i ve a n d d e s c r i b e s t h e
current state of knowledge, of study findings, comparison with contribution made by and the
enlisting knowledge gaps, available evidence, enlisting strengths and significance of the study. Many a
importance of bridging weaknesses of the study, interpretation times, it decides if the manuscript
the knowledge gap and of the whole evidence, discussion on the
stating the hypothesis or the external validity and impact of the study will be accepted for publication or
research question findings and recommendations for future not. Hence, it is necessary for the
course of action authors to plan it well, and write it
Flow and From general information to From specific study findings to in a focused manner describing the
Organization specific study objectives implications for the relevant general
significance and importance of the
population
study findings.
well. Before beginning to write to the instructions to authors that
the section, the authors should journals provide. Though most References
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